NJ S2314

Commissioner of Banking and Insurance gains authority to investigate and bar health care providers from receiving reimbursement under personal injury protection (PIP) coverage for auto insurance claims.

Grounds for investigation include professional misconduct, billing for services never rendered or medically unnecessary, making false statements in medical reports, improper solicitation of patients, or refusing to cooperate with state officials.

Health care providers must receive at least 90 days advance notice of new regulations and are entitled to due process protections including notice and opportunity to be heard before any suspension or bar.

Commissioner may temporarily suspend providers from PIP reimbursement for up to 90 days during an investigation, following a hearing and written notice.

A public list of barred providers must be maintained and made available via state agency websites and a toll-free number; barred providers cannot treat PIP patients for payment even as private patients.